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Payment Policies

Co-payments are due and are collected at Registration before appointment(s). A co-payment amount is determined by the patient’s specific health plan. All co-payments are the responsibility of the patient.

Co-Insurance is a percentage of the cost according to the patient’s health plan for specific medical care and/or treatment. Co-insurance payments are the responsibility of the patient and are due prior to service.

Deposits are required when the service is not covered by insurance or the patient does not have insurance. The Deposit is collected before the appointment and patients will be billed for any additional charges. Deposit amounts may vary by department or type of procedure.

Cancellation Fee: If a patient is a no-show for their appointment or if they cancel their appointment less than 24 hours before their scheduled appointment time, the patient may be responsible for a $30 cancellation fee. Exceptions to the cancellation fee include emergencies and other unavoidable circumstances.

Patients who may have financial difficulties are encouraged to contact a Patient Accounts representative at (805) 681-1760 to discuss a suitable payment plan to meet their financial responsibilities.

Sansum Clinic does not specifically reward providers or other individuals for issuing denials of coverage.

No incentives are paid to physician reviewer to deny services. All denials made regarding medical necessity are reviewed and determined not medically indicated by a physician or specialist reviewer, as appropriate. Review criteria is available to the public upon request to the Managed Care Referrals Department.

Managed Care Referrals Department - Any Utilization Management questions, please contact: 

(800) 281-4425 - California
(800) 472-6786 - Outside of California

    For informational purposes only, a link to the federal Centers for Medicare and Medicaid Services (CMS) Open Payments web page is provided here. The federal Physician Payments Sunshine Act requires that detailed information about payment and other payments of value worth over ten dollars ($10) from manufacturers of drugs, medical devices, and biologics to physicians and teaching hospitals be made available to the public.